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. 2019 Feb;145(2):503-509.
doi: 10.1007/s00432-018-2814-2. Epub 2018 Dec 7.

Preoperative brain MRI for clinical stage IA lung cancer: is routine scanning rational?

Lingdun Zhuge  1   2 , Yangle Huang  1   2 , Shengfei Wang  1   2 , Juntao Xie  1   2 , Binhao Huang  1   2 , Difan Zheng  1   2 , Shanbo Zheng  1   2 , Yue Zhao  1   2 , Hengyu Mao  1   2 , David O Wilson  3 , James D Luketich  4 , Jiaqing Xiang  1   2 , Haiquan Chen  5   6 , Jie Zhang  7   8   9
Affiliations

Preoperative brain MRI for clinical stage IA lung cancer: is routine scanning rational?

Lingdun Zhuge et al. J Cancer Res Clin Oncol. 2019 Feb.

Abstract

Purpose: Early detection and control of lung cancer brain metastases (BMs) are important. However, several guideline recommendations are inconsistent with regard to routine preoperative brain MRI, especially in patients with clinical stage IA lung cancer. Our study evaluated the value of preoperative brain MRI in patients with clinical stage IA lung cancer.

Methods: A retrospective analysis of patients with lung cancer was performed using a prospectively collected database. Clinical data and the results of brain MRI were collected and analyzed.

Results: Patients with pathologically proved primary lung cancer who underwent an MRI at initial diagnosis were identified (3392 patients). In total, 170 patients (5.0%) were diagnosed with BMs. The increased frequency of BMs was significantly associated with advanced clinical stage (P = 0.000) and pathological type (P = 0.011). BMs were detected in 11 out of 1595 patients with clinical stage IA lung cancer (0.7%). BMs were more common in patients with clinical stage cT1c lung cancer (1.9%) than those with clinical stage cT1a or cT1b (0.1%, odds ratio = 21.30, 95% confidence interval: 2.7-166.9, P = 0.000). All patients with stage IA lung cancer and BMs had solid lung lesions (P = 0.002).

Conclusions: Preoperative brain MRI might help identify BMs in patients with lung cancer that has progressed beyond stage IA. In patients with clinical stage IA lung cancer, we do not recommend preoperative brain MRI, but it may potentially be beneficial in those with solid T1c cancers.

Keywords: Brain MRI; Brain metastases; Lung cancer.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Criteria for selection and exclusion of research subjects
See this image and copyright information in PMC

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